Provider Demographics
NPI:1922761196
Name:CARLISI, EMILY (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:CARLISI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 OSBORNE AVE UNIT B9
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06855-1010
Mailing Address - Country:US
Mailing Address - Phone:516-551-1575
Mailing Address - Fax:
Practice Address - Street 1:139 FULTON ST RM 901
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2531
Practice Address - Country:US
Practice Address - Phone:929-346-1907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF348248-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily